Showing posts with label #mulgrewcare. Show all posts
Showing posts with label #mulgrewcare. Show all posts

Saturday, July 8, 2023

Retiree Advocate Newsletter: Good News on UFT Retiree Healthcare: Judge Frank Grants TRO for Switch to MAP

I was going to post on some of these issues, so this is welcome relief from doing the work. Thanks RA. I will be back later today with more on the healthcare issue and the mystery of the missing contract outcome, probably buried in the catacombs.

 

                                                       July, 2023

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Retiree Advocate is a member of  UNITED FOR CHANGE

Nick Bacon, New Action Caucus, July 7

Today, Judge Lyle Frank
granted a TRO (temporary restraining Order) which will temporarily halt the City and the MLC from switching all retirees from GHI SeniorCare to a for-profit Aetna Medicare Advantage Plan. While the case is far from over, this is a very good omen. These excerpts in particular bode well:  

“First, the Court finds that the petitioners have shown by clear and convincing evidence that there is a likelihood of success on the merits. The Court agrees that it is likely that this Court will ultimately find that the respondents are estopped from switching retirees into a Medicare Advantage Plan and that New York City Administrative Code section 12-126 does not permit the action that the City plans to take….The petitioners have shown that numerous promises were made by the City to then New York City employees and future retirees that they would receive a Medicare supplemental plan when they retired, and that their first level of coverage once that retired would by Medicare.”

Make no mistake: the timing of this TRO decision alongside a new contract that is almost sure to be ratified within the next several days is meaningful. Mulgrew’s nightmare scenario of a ratified contract followed by the necessity of making major negative changes to in-service health care plans now seems more likely and more imminent than it did before. Mulgrew, after all, will still need to find savings to pay back the City for promised healthcare spending reductions. Now, however, he will have to pillage elsewhere than our retiree coverage. For those next steps, we must wait and see; against those next steps, we must be ready to fight.

For more from the New Action / UFT Blog, check out the website here.


More information

From the PSC
 The decision temporarily enjoins the City, until further order of the court, from requiring any City retirees and their dependents from being removed from their current health insurance plans and from being required to either enroll in an Aetna MA Plan or seek their own coverage.  The court said they plaintiffs met the standards for winning a preliminary injunction, as 1) they have a likelihood of succeeding on the merits of their first cause of action, which alleges the city made a  promise of future Medicare benefits that retirees relied on "to their detriment" (making a decision based on that promise that concretely affects them, such as not taking another job), 2) there would be "irreparable harm" if they have to wait to complete litigation before receiving a court decision, and 3) the "balance of equities" (is the harm greater from granting or not granting an injunction?) favor the plaintiffs.
 
It can be difficult to appeal from the issuance of an injunction, as normally appeals are heard only from final decisions. Nevertheless, it's fair to assume the City will appeal. Meanwhile, the judge will begin a process in which he requires the City to provide evidence that satisfies him that, for example, retirees won't be denied coverage/treatment they would have received under Medicare.


More from the NYC Organization of Public Service Retirees.  Please note that the good news is only temporary in that:
There will be subsequent hearings in court to determine if the Temporary Restraining Order should become "permanent" or if it should be lifted, and if so, on what basis;

The City still has pending before the state Court of Appeals the appeal it filed on last year's case (which had said that the City does have the right to offer the Medicare Advantage Plan (the one it had offered before) but that the City has no right to auto enroll us or to make us pay for our already-existing Medigap plan).  We do not yet know what the status of that Court of Appeals case is - whether the Court will allow it to continue, or dismiss it or what.

The City still has an appeal pending on the 'co-pay' case.
We still need the City Council to pass Int. 1099-2023 so that we can permanently secure our rights to our existing health insurance benefits without having to go back and forth to court - a very unaffordable and time/labor-intensive process.

So the organization has asked that we continue to donate (details below) for the mounting legal expenses and try to get our friends and others impacted by the City retiree health insurance rules and policies to do the same.

TO DONATE, HERE ARE SEVERAL SIMPLE WAYS!

1.  Make Your Check or Money Order payable to 
    
 
NYC Organization of Public Service Retirees 
     Mail to:
NYC Organization of Public Service Retirees 
c/o JSH Accounting Services, LLC        
PO Box 143538       
Fayetteville, GA 30214


For your convenience, you can set-up AutoPay with your banking institution so that you can determine an amount and date to have funds automatically transferred.

2.   PayPal (Click to link to their Secure Site, a PayPal Account is not required.  The organization is charged a fee) 

3.   ZELLE: (Go to Your "On-Line" Banking Website) Locate the ZELLE service & use our email:
      NYCOrgofpublicserviceretirees@gmail.com    
Check with your Bank to understand how ZELLE works. It's usually a service on their website.  When you locate and fill out the form and you are asked for the email or phone number, use the email address, above. Make sure it's correct! No phone number is required. The next time you use Zelle, the email should pop into that field.  You can check your bank account to make  sure the transaction went through. It's Quick & Easy

4.   VENMO: We Now Accept Donations via VENMO (The Organization is charged a fee.
VENMO is a Phone App or can be used on a PC or Tablet.
You can download and install the Phone App from the Android Play Store or Apple App Store. Please follow the instructions to Sign Up. Please read and understand how VENMO works before you donate! There may be fees involved using this method.

Our ID is: @NYCRetirees2
Here is a quick Venmo  Tutorial:


Why do we need a petition to request a member-wide referendum to vote on healthcare changes?  


According to the UFT Constitution, members can demand a member-wide referendum vote on any issue other than a constitutional amendment or actions on the status of an individual member.  First, ten percent of the membership must petition the UFT executive board for a referendum, and then the executive board must bring the matter to the entire body for a member-wide vote.  Given the serious nature of the healthcare changes that have been made without member input or democratic decision-making, we must take this matter into our own hands.

So sign this petition today. We deserve a say on healthcare.

Quick Facts
  • Mulgrew voted in the Municipal Labor Committee (MLC) to force retired City workers off of traditional Medicare and onto an Aetna-managed Medicare Advantage Plan (MAP). Despite knowing full well that there was significant opposition, Mulgrew denied membership the right to vote directly. 
  • Major changes to our healthcare were made as part of our citywide contracts in 2014, and again in 2018.  Mulgrew was instrumental in negotiating both. In the last healthcare agreement, in 2018, he agreed to $600 million dollars in healthcare savings for the City for every year, in perpetuity. These changes and agreements were negotiated behind closed doors without member input. UFT chapter leaders and delegates were not given Appendix A to read beforehand which delineated the healthcare concessions when they voted in support of our 2018 contract.  
  • UFT Leadership is currently working on a mysterious new health plan for in-service members that would replace GHI with something cheaper. As of now, membership will not have a say in this decision either, or given meaningful details about our potential options.
  • Even without switching us off of GHI, UFT leadership has greenlit various new, significant healthcare expenses for in-service members without a membership vote. 
For instance:
  • ER visits now cost us triple digit copays, which are waived only if a patient is admitted, even if they are deemed to need emergency care. 
  • Copays for most urgent care centers (including CityMD) have also risen to triple digits, from $15 to $100, since 2016.
  • Major providers, such as CityMD, Montefiore, and almost all radiology centers, are no longer ‘preferred,’ leading to higher copays.
  • Despite many healthcare expenses more than doubling, UFT leadership has not fought for fair increases in pay. Because we did not even attempt to stop DC37 from accepting a sub-inflation wage increase, UFT members will not only be seeing higher health costs – they’ll be taking a pay cut
Want More Answers?

From the PSC.  A very thorough list of questions and answers
Medicare Rights- Medicare Interactive
Choosing a Medigap Policy - 2023 Medicare

Consumer reports choosing a drug plan
UFT Retiree Health Care Update May 16
Advocacy and phone counselors from Medicare Rights

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Saturday, June 3, 2023

The May 24 rally - Medicare switch looms, but retirees’ opposition persists - The Chief -

Congrats to reporter Charlotte Robertson who is interning at The Chief this summer and this was her first assignment. Nice job.
 
There is another rally at the UFT DA Wednesday June 7 supporting the NY Health Act and yet another at City Hall on Thursday June 8 at 11.
Oy, when do we go to the beach?
 
Also note this:
NYC Retirees are organizing with retirees from several other states to escalate the campaign against forced enrollment in Medicare Advantage. Along with 39,000+ other current and future retirees, I wrote a letter for the Action Network letter campaign: End Auto Enrollment into Medicare Advantage. Let's contact our Elected Officials and let them know how forcing us into Medicare Advantage plans will negatively impact us.

It takes just a few minutes to send your letter thru this link: https://actionnetwork.org/letters/roll-back-medicare-advantage-auto-enrollment?source=email&

Thanks!

WHAT I WROTE (& other info on Medicare Advantage & auto-enrollment below):

We are American Retirees & future retirees from all over the country, who are all facing the same issue, having our former employer or union auto-enroll us into a Privatized – For- Profit Medicare Advantage plan and removing us from Traditional Medicare with a supplement.

Medicare Advantage Plans were founded to be a choice, not a mandate. They are inferior to Traditional Medicare, can cost more for some retirees, and many providers do not accept them, leaving retirees without continuity of care. As elected officials, you have surely heard that many of these insurers are under investigation by the Department of Justice for Medicare fraud and that the Health and Human Services Office of the Inspector General found these insurers to wrongly delay and deny care. If we are to protect the Medicare Trust Fund, we should not be allowing private insurers to drain the public coffers by up-coding and putting a burden on the American taxpayers.

The Center for Medicare Advocacy stated, “in December 2000, a provision was added to the statute regarding employer or union sponsored group Medicare Advantage (MA) plans, which gave the secretary the broad authority to ‘waive or modify requirements that hinder the design of, the offering of, or the enrollment in [such MA] plans. This provision paved the way for the creation of the automatic enrollment process whereby employers or unions could automatically enroll their retirees in an MA plan so long as they provide advance notice and a mechanism to opt out.”

Sadly, they were not required to provide a plan to opt out into, leaving them only to re-enroll themselves into traditional Medicare but most likely without a supplemental plan. That is because you would be subject to underwriting if over 65, and in many cases no access or expensive premiums if you are disabled and under 65.

We implore you to roll back this statute (42 U.S.C.A. § 1395w-27 (West 2003))that was implemented with no public comment period in 2000, and allow Americans the ease of access to Traditional Medicare that has been customary and requires the employers and unions to live up to the promises they made to retirees. In many situations, retirees will be forced to remain in Medicare Advantage because they cannot afford to "opt out." This only benefits the Insurer and not the Medicare Beneficiary or the United Stated Medicare Trust. This also permits the unions and employers to cease providing promised benefits to retirees who can no longer negotiate as because they are no longer employed. Many of us are currently fighting for our earned and paid for Federal Medicare. Some are in Continuing Care Residential Communities where Medicare Advantage is not accepted and many of our doctors do not accept them either.

STATE ELECTEDS: While this is a FEDERAL STATUTE ISSUE, Elected Officials on the STATE LEVEL MUST be aware, as this is affecting YOUR constituents! Employers and unions NATIONWIDE, are "auto enrolling" retirees; the disabled and seniors, into these plans and out of Traditional Medicare where they may never be able to secure a supplemental plan (pays the last 20% of medical bills Medicare does not) because of a lack of State wide guarantee issue rights.

The Federal government should not be permitting retirees, seniors and the disabled to be auto enrolled into privatized Medicare plans and out of Federal Medicare that they paid into since they earned their first paycheck.

We urge you to support retirees who want to remain enrolled in Medicare with the Supplement they were promised decades ago. Many of our former employers or unions made promised to us. Now, is not the time to renege on them.

Yours truly,


Links to articles: https://www.nytimes.com/2022/10/08/upshot/medicare-advantage-fraud-allegations.html

HHS OIG: https://oig.hhs.gov/oei/reports/oei-09-18-00260.asp

https://oig.hhs.gov/oei/reports/OEI-03-21-00380.asp


MEDICARE ADVOCACY AUTO ENROLLMENT: https://medicareadvocacy.org/wp-content/uploads/2021/10/Issue-Brief-MA-Auto-Enrollment.pdf

 
 

Medicare switch looms, but retirees’ opposition persists

Posted Saturday, May 27, 2023 3:01 pm
BY CHARLOTTE ROBERTSON
Even as the city proceeds with a shift of its 250,000 municipal retirees to a private Medicare Advantage plan, scheduled for Sept. 1, former city workers continue to voice their opposition, if in fewer numbers. 
As they have on occasion since city officials announced the change, dozens gathered near City Hall Wednesday to once again denounce the effort. 
“We will fight this as long as we have to,” said Sarah Shapiro, a former city teacher of 28 years and United Federation of Teachers retiree. She has been protesting the Advantage plan for the past two years. 
Shapiro, sporting a baseball cap inscribed “Adams Screws Retirees,” said she remained determined. “I’ve been around, and so have these other retirees. We’ve worked our entire lives for the city,” she said. “We have been active in our unions our entire lives. We are aware and we are engaged.”
Following years of litigation, push-back from former municipal workers and a contentious arbitrator's ruling, Adams administration officials signed the five-plus year contract with the managed-care company in early April. The administration’s endorsement followed ratification of the Aetna contract by the Municipal Labor Committee, the umbrella group of city unions, a month earlier. 
Both the de Blasio and Adams administrations have argued that the switch was necessary given the escalating cost of health care. Officials have said the switch will save the city about $600 million a year. The savings, in the form of federal subsidies, will be funneled into the city’s Joint Health Insurance Premium Stabilization Fund, which finances the unions’ welfare-fund benefits, among other purposes.
Ever since its conception, though, municipal retirees have fiercely opposed the Medicare Advantage plan — or “DisAdvantage plan,” as some referred to it on numerous posters and banners they carried during their rally, arguing that quality of care offered by the managed-care giant would pale in comparison to their plans.
‘There are alternate ways’
The rally took place as the City Council’s Finance Committee conducted hearings on the executive budget, inviting testimony from residents. 
“We thought we would have our own public hearing outside about our issue,” said Gloria Brandman, another UFT retiree and founding member of the Cross-Union Retirees Organizing Committee (CROC). Echoing Shapiro, she emphasized that retirees had no significant say in regarding a proposed plan switch. 
“There are alternate ways for the city to save money. It is a small percentage of the budget, it is very small, what this would save,” she said.
Shapiro noted that retiree health care will consume less than 1 percent of the city’s $105 billion budget. “Don’t we matter? After years and years of dedication to the city?” she asked. 
Retirees argue that the Advantage plan will place limitations on their care. Brian Wonsever, who worked in the Department of Homelessness Services for 33 years before retiring, noted that while the vast majority of doctors accept traditional Medicare, far fewer accept private Medicare plans. 
Opting out of the Advantage plan and into HIP VIP plan, he continued, would cost people about at least $6,000 a year. “It’s a matter of choice,” he said.
But some have argued that many don’t have that choice, saying they accepted lower salaries to work for the city in return for the promise of superior health benefits in retirement. 
Without that, many said they were struggling to envision a healthy future — with even some current city workers becoming fearful. “I soon plan to retire and I see that it’s going down the drain,” said Anatoly Kantorovich, a current employee at the Department of Health and a self-described retiree-in-training. 
Across the board, the retirees argued that the Advantage plan prioritizes money over adequate and accessible care. “I’m just going to say it plain: If you have ever dealt with an insurance company, you know they are not about efficiency,” Wonsever declared. 
Camillo Biener, who retired from the Human Resources Administration after 26 years with the city, agreed. “It’s a total fallacy, the efficiency argument,” he said. 
“Medicare Advantage gives less than Medicare. So what happens essentially is that these companies that run these plans get more money, and they give less services,” Biener said. “Does that make any sense at all?” 
A faction of UFT members opposed to the switch — which was supported by the union’s president, Michael Mulgrew — has since begun petitioning for a vote regarding any future proposed changes to health-care plans. “Our union never asked us if we wanted to change our health plan,” Brandman summarized.
The retirees read dozens of testimonies from those who could not attend the rally, some because of health issues. 
Shortly before 11 a.m., the retirees headed from City Hall Park toward where Mayor Eric Adams was dedicating new public space under the Brooklyn Bridge. Biener followed, walking his dog, who wore a sign reading, “If my daddy dies because he had to wait too long for pre-approval, who will take care of me?” 
As he walked to the bridge, Beiner told The Chief, “My suggestion to all the media and everybody is to follow the money. … I wish somebody would look into this stuff, because this thing is a lot deeper, and a lot more troubling, than what people think.” 
Shapiro, while frustrated and angry, retained some optimism. “We want to remind everybody that retirees vote,” she said. “We cannot risk the demise of public Medicare when these ‘Medicare disadvantage’ plans are taking over the market.”